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Cancers 2011, 3(2), 2176-2194; doi:10.3390/cancers3022176

Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy

2,3,*  and 1
1 Department of Oncology and Surgical Sciences, Section of Surgery, University of Padova, Padova 35128, Italy 2 Istituto Oncologico Veneto-IRCCS, Padova 35128, Italy 3 Department of Oncology and Surgical Sciences, Section of Oncology, University of Padova, Padova 35128, Italy
* Author to whom correspondence should be addressed.
Received: 11 March 2011 / Revised: 8 April 2011 / Accepted: 11 April 2011 / Published: 26 April 2011
(This article belongs to the Special Issue Prognostic and Predictive Factors in Colorectal Cancer)
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Locally advanced rectal cancer is currently treated with pre-operative radiochemotherapy (pRCT), but the response is not uniform. Identification of patients with higher likelihood of responding to pRCT is clinically relevant, as patients with resistant tumors could be spared exposure to radiation or DNA-damaging drugs that are associated with adverse side effects. To highlight predictive biomarkers of response to pRCT, a systematic search of PubMed was conducted with a combination of the following terms: “rectal”, “predictive”, “radiochemotherapy”, “neoadjuvant”, “response” and “biomarkers”. Genetic polymorphisms in epithelial growth factor receptor (EGFR) and thymidylate synthase (TS) genes, the expression of several markers, such as EGFR, bcl-2/bax and cyclooxygenase (COX)-2, and circulating biomarkers, such as serum carcinoembryonic antigen (CEA) level, are promising as predictor markers, but need to be further evaluated. The majority of the studies did not support the predictive value of p53, while the values of Ki-67, TS and p21 is still controversial. Gene expression profiles of thousands of genes using microarrays, microRNA studies and the search for new circulating molecules, such as human telomerase reverse transcriptase mRNA and cell-free DNA, are providing interesting results that might lead to the identification of new useful biomarkers. Evaluation of biomarkers in larger, prospective trials are required to guide therapeutic strategies.
Keywords: rectal cancer; neoadjuvant therapy; biomarkers rectal cancer; neoadjuvant therapy; biomarkers
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Spolverato, G.; Pucciarelli, S.; Bertorelle, R.; De Rossi, A.; Nitti, D. Predictive Factors of the Response of Rectal Cancer to Neoadjuvant Radiochemotherapy. Cancers 2011, 3, 2176-2194.

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